Endocrine Abstracts

Background and Aim: Patients with type1 and type2 diabetes both have a high prevalence of depressive symptoms. The aim of this study was to evaluate the prevalence of depressive symptoms and associated factors in patients with diabetes.

Methods: This is a cross-sectional study conducted in 140 patients with diabetes. Patients’ demographic characteristics, current treatments, glycemic control, cardiovascular risk factors, diabetes-related complications were collected. Treatment adherence was evaluated by Medication Adherence Questionnaire (MAQR) of Morisky-Green. Tobacco dependence was evaluated by the Mini fagerstrom test. Patients were asked to complete the 9-item Patient Health Questionnaire(PHQ-9)to evaluate depressive symptoms. Total PHQ-9 score ranges from 0 to 27. In this study, we combined scores10–27 (“moderately severe or severe”) to improve precision of estimates. We defined PHQ-9 total scores ≥10 as clinically relevant depression(CRD)[1].

Results: Of the study population, mean age was 54.88±12.97 years with female predominance (55.6%),87.3% of patients had type 2 diabetes. Mean diabetes duration was 13.43±7.3 years, mean glycated hemoglobin was 9.7% ±1.76 and mean BMI was 28.3± 7.5Kg/m². Among the subgroup of type 2 diabetes patients,20.4% of patients used oral glucose-lowering drugs(OGLDs) only, and 79.6% used OGLDs plus insulin, In the whole population study,70.5% reported depressive symptoms(PHQ-9 score⩾5) and 36% had CRD. CRD was significantly associated with female sex (70%vs46,1%; P=0,007), high tobacco dependance (100% vs 57%; P=0,01) and poor treatment adherence (54% vs 36 %; P=0,03). Patients with CRD had higher total cholesterol (4.67±1.22 mmol/l vs 4.14± 0.98 mmol/l; P=0.008), higher HDLc(1.31± 0.59 mmol/l vs 1.12 ± 0.27mmol/l; P=0,012) and higher LDLc(1.06±0.35 vs 0.91±0.3mmol/l; P=0.015). Diabetes treatment, type of diabetes, microvascular and macrovascular complications did not statisticcaly differ between the two groups.

Conclusion: Depressive symptoms are common in patients with diabetes calling for routine screening to reduce the double burden of diabetes and depression and their negative interaction.

References: 1. Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. CMAJ Can. Med. Assoc. J. J. Assoc. Medicale Can. 2012;184:E191-196.